People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Science Daily reported in How can we prevent suicide? Major study shows risk factors associated with depression:

A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death in men under 35) see notes, below. Effective measures of suicide prevention are urgently needed.

The BRIDGE-II-MIX study is a major international study looking at depression and suicide. The researchers evaluated 2811 patients suffering from depression, of whom 628 had already attempted suicide. Each patient was interviewed by a psychiatrist as if it were a standard evaluation of a mentally-ill patient. The parameters studied included previous suicide attempts, family history, current and previous treatment, patients’ clinical presentation, how they scored on the standard Global Assessment of Functioning scale, and other parameters. The study looked especially at the characteristics and behaviours of those who had attempted suicide, and compared these to depressed patients who had not attempted suicide. They found that certain patterns recur before suicide attempts.

According to author Dr. Dina Popovic (Barcelona):
‘We found that “depressive mixed states” often preceded suicide attempts. A depressive mixed state is where a patient is depressed, but also has symptoms of “excitation,” or mania. We found this significantly more in patients who had previously attempted suicide, than those who had not. In fact 40% of all the depressed patients who attempted suicide had a “mixed episode” rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide.
We also found that the standard DSM criteria identified 12% of patients at showing mixed states, whereas our methods showed 40% of at-risk patients. This means that the standard methods are missing a lot of patients at risk of suicide.”

In a second analysis of the figures, they found that if a depressed patient presents any of the following symptoms:

• risky behaviour (e.g. reckless driving, promiscuous behaviour)
• psychomotor agitation (pacing around a room, wringing one’s hands, pulling off clothing and putting it back on and other similar actions)
• impulsivity (acting on a whim, displaying behaviour characterized by little or no forethought, reflection, or consideration of the consequences),
then their risk of attempting suicide is at least 50% higher.http://www.sciencedaily.com/releases/2015/08/150830152601.htm

Citation:

How can we prevent suicide? Major study shows risk factors associated with depression
Date: August 30, 2015

Source: European College of Neuropsychopharmacology

Summary:

A major multi-national study of suicides has identified the behavior patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity.

METHOD:

This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression.

RESULTS:

Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode > 1 month, atypical features, early onset, history of antidepressant-induced mania/hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder.

Here is the press release from the European College of Neuropsychopharmacology:

Public Release: 29-Aug-2015 How can we prevent suicide? Major study shows risk factors associated with depression

European College of Neuropsychopharmacology

A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts.

The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death in men under 35) see notes, below. Effective measures of suicide prevention are urgently needed.

The BRIDGE-II-MIX study is a major international study looking at depression and suicide. The researchers evaluated 2811 patients suffering from depression, of whom 628 had already attempted suicide. Each patient was interviewed by a psychiatrist as if it were a standard evaluation of a mentally-ill patient. The parameters studied included previous suicide attempts, family history, current and previous treatment, patients’ clinical presentation, how they scored on the standard Global Assessment of Functioning scale, and other parameters. The study looked especially at the characteristics and behaviours of those who had attempted suicide, and compared these to depressed patients who had not attempted suicide. They found that certain patterns recur before suicide attempts.

According to author Dr. Dina Popovic (Barcelona):
‘We found that “depressive mixed states” often preceded suicide attempts. A depressive mixed state is where a patient is depressed, but also has symptoms of “excitation”, or mania. We found this significantly more in patients who had previously attempted suicide, than those who had not. In fact 40% of all the depressed patients who attempted suicide had a “mixed episode” rather than just depression. All the patients who suffer from mixed depression are at much higher risk of suicide.

We also found that the standard DSM criteria identified 12% of patients at showing mixed states, whereas our methods showed 40% of at-risk patients. This means that the standard methods are missing a lot of patients at risk of suicide”.

In a second analysis of the figures, they found that if a depressed patient presents any of the following symptoms:

• risky behaviour (e.g. reckless driving, promiscuous behaviour)
• psychomotor agitation (pacing around a room, wringing one’s hands, pulling off clothing and putting it back on and other similar actions)
• impulsivity (acting on a whim, displaying behaviour characterized by little or no forethought, reflection, or consideration of the consequences),
then their risk of attempting suicide is at least 50% higher.
Dr Popovic continued:

“In our opinion, assessing these symptoms in every depressed patient we see is extremely important, and has immense therapeutical implications. Most of these symptoms will not be spontaneously referred by the patient, the clinician needs to inquire directly, and many clinicians may not be aware of the importance of looking at these symptoms before deciding to treat depressed patients.

This is an important message for all clinicians, from the GPs who see depressed patients and may not pay enough attention to these symptoms, which are not always reported spontaneously by the patients, through to secondary and tertiary level clinicians. In highly specialized tertiary centres, clinicians working with bipolar patients are usually more aware of this, but that practice needs to extent to all levels.

The strength of this study is that it’s not a clinical trial, with ideal patients – it’s a big study, from the real world”.
Commenting ECNP President, Professor Guy Goodwin (Oxford) said:

The recognition of increased activation in the context of a severe depression is an important practical challenge. While many psychiatrists recognize that this constitutes an additional risk for suicide, and would welcome better scales for its identification, the question of treatment remains challenging. We need more research to guide us on best practice. http://www.eurekalert.org/pub_releases/2015-08/econ-hcw082615.php

American public schools have made a clear trade-off over the past few decades. With the twin goals of improving the math performance of the average student and promoting equality, it has made the curriculum more accessible. The drawback to exclusive use of this more accessible curriculum can be observed among the nation’s top-performing students, who are either less willing or less able than their predecessors or their high-achieving global peers to follow the career paths in math, science, and engineering that are the key to innovation and job creation. In the name of preparing more of the workforce to take those jobs, we have harmed the skills of those who might have created them. Although there is some evidence of a payoff from this sacrifice, in the form of marginally better performance among average students, some of the strategies used to help these students have in fact backfired…

Not all children are equally prepared to embark on a rigorous math curriculum on the first day of kindergarten, and there are no realistic policy alternatives to change this simple fact. Rather than wish differences among students away, a rational policy for the 21st century will respond to those variations, tailoring lessons to children’s needs. This strategy promises to provide the next generation of prospective scientists and engineers with the training they need to create jobs, and the next generation of workers with the skills they need to qualify for them. http://educationnext.org/solving-america%E2%80%99s-math-problem/#.UG25FCk_6rE.email

One way of looking at Vigdor’s conclusions is to ask whether high performance preschool programs and early intervention can affect student achievement?

Brain scans may be able to predict which kids are likely to improve their math skills in school and which ones are not, and they do it better than IQ or math tests, researchers reported Tuesday.
The researchers have been working with a group of kids who started getting brain scans at the age of 8, and who have followed up with tests into their mid-teens.

To their surprise, the researchers found that certain patterns of brain activity when the kids were not doing anything at all at age 8 predicted how much they would improve their math skills over the years. And these scans did so with far more accuracy than did intelligence tests, reading tests or math tests, they report in the Journal of Neuroscience.
While it’s far too soon to stick every kid into a brain scanner, the findings may eventually lead to ways to identify the children who’d benefit most from intensive math coaching, the researchers said…. http://www.nbcnews.com/health/kids-health/brain-scans-may-predict-math-gains-study-finds-n412141

Brain scans better forecast math learning in kids than do skill tests, study finds
Gray matter volume and connections between several brain regions better forecast 8-year-olds’ acquisition of math skills than their performance on standard math tests.
Vinod Menon and his colleagues found that scans of brain structures indicated which childen would be the best math learners over the next six years.

Brain scans from 8-year-old children can predict gains in their mathematical ability over the next six years, according to a new study from the Stanford University School of Medicine.
The research tracked 43 children longitudinally for six years, starting at age 8, and showed that while brain characteristics strongly indicated which children would be the best math learners over the following six years, the children’s performance on math, reading, IQ and memory tests at age 8 did not.

The study, published online Aug. 18 in The Journal of Neuroscience, moves scientists closer to their goal of helping children who struggle to acquire math skills.
“We can identify brain systems that support children’s math skill development over six years in childhood and early adolescence,” said the study’s lead author, Tanya Evans, PhD, postdoctoral scholar in psychiatry and behavioral sciences.

“A long-term goal of this research is to identify children who might benefit most from targeted math intervention at an early age,” said senior author Vinod Menon, PhD, professor of psychiatry and behavioral sciences. “Mathematical skills are crucial in our increasingly technological society, and our new data show which brain features forecast future growth in math abilities.”
At the start of the study, the children received structural and functional magnetic resonance imaging brain scans. None of the kids had neurological or psychiatric disorders, and their intelligence fell in a range considered normal for their age. The scans were conducted while the children lay quietly in the scanner; the scans measured brain structure and intrinsic functional connections between brain regions, and were not tied to performance on any particular math task.

The 8-year-olds also took standardized tests (given outside the scanner) to measure IQ, as well as reading, math and working-memory skills. All of the children returned for at least one follow-up assessment of these skills before age 14, and many children had other additional follow-ups.

Surprising results

The scientists were surprised by the extent and nature of the connections between brain regions that predicted the development of the children’s math skills. Greater volume and connectivity of two areas forecast skill development: the ventro-temporal occipital cortex, which is a brain region that supports visual object perception, and the intra-parietal sulcus, which helps people compare and make judgements about numbers, such as understanding that four is more than three. The strength of these regions’ interconnections with the prefrontal cortex was also predictive. The work identifies a network of brain areas that provides a scaffold for long-term math skill development in children, Menon said.

The 8-year-olds’ initial IQ, reading, working-memory and math scores did not predict long-term learning in math. The lack of predictive ability of standard math tests taken at age 8 suggests that brain features more precisely predict children’s math learning, Evans said. The brain scans capture many different aspects of information processing, thus better forecasting which children will fall behind and which will excel, Menon added.
Just because a child is currently struggling doesn’t necessarily mean he or she will be a poor learner in the future.
“Next, we are investigating how brain connections change over time in children who show large versus small improvements in math skills, and designing new interventions to help children improve their short-term learning and long-term skill acquisition,” Menon said. Although it is still impractical to give brain scans to children on a large scale, the team’s studies provide a baseline understanding of normal development that will help experts develop and validate remediation programs for children with learning disabilities, he noted.
In the meantime, the team’s findings suggest that parents and teachers should encourage children to exercise their mental math muscles. “Just because a child is currently struggling doesn’t necessarily mean he or she will be a poor learner in the future,” Evans said.

All brain scans were conducted at the Richard M. Lucas Center for Imaging at the School of Medicine.
The research was funded by grants from the National Institutes of Health (grants HD047520, HD059205 and HD080367), Stanford’s Child Health Research Institute, the Lucile Packard Foundation for Children’s Health, Stanford’s Clinical and Translational Science Award (NIH grant UL1RR025744) and the Netherlands Organization for Scientific Research. Menon is a member of Stanford’s Child Health Research Institute.
Information about Stanford’s Department of Psychiatry and Behavioral Sciences, which also supported the research, is available at http://med.stanford.edu/psychiatry.html.